Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Wheelchairs”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed2003

Shoulder pain: a comparison of wheelchair athletes and nonathletic wheelchair users.

PURPOSE: The purpose of this study was to directly compare the onset and prevalence of shoulder pain in athletic and nonathletic wheelchair users. METHODS: A questionnaire was distributed to athletic and nonathletic wheelchair-dependent populations. This inquired about presence and duration of shoulder pain, age of subject, level of injury, duration of time since injury, wheelchair use, involvement in sports, and training habits. A total of 257 subjects were involved in the study. RESULTS: The odds of having shoulder pain were twice as high among nonathletes as they were among athletes. This finding represents a significant difference over and above age differences, differences in years spent in a wheelchair, and differences in level of spinal cord injury. Athletes also have an average of 12 yr free of shoulder pain after becoming wheelchair bound, whereas nonathletes have only 8 yr. CONCLUSION: Promotion of active exercise for wheelchair users is encouraged to decrease shoulder pain, resulting in more functional, pain-free years.

Exercise↗
PubMed1995

Improvement in wheelchair propulsion in pediatric wheelchair users through resistance training: a pilot study.

Six children, three with cerebral palsy and three with myelomeningocele, participated in a progressive, 8-week, circuit muscular strength training program. The program was designed to improve wheelchair propulsion, an important functional outcome. Subjects performed three sets of six-repetition maximum (6-RM) upper body strength exercises, three times a week. Exercises included shoulder flexion, extension, abduction, internal and external rotation, elbow flexion, extension, and shoulder flexion/elbow extension (bench press). Subjects exercised quickly with little rest between each set for approximately 30 minutes per session. All children used wheelchairs extensively and participated in a 50-m, and a 12-minute wheelchair propulsion test before and after the 8-week program. The sign test was used to determine if statistically significant (P < or = .05) wheelchair propulsion or 6-RM changes occurred over the training period. Subjects improved significantly (P < or = .031) in all muscular strength (6-RM) measures and the 12-minute distance test. There was a trend toward improvement in the 50-meter test, although this change was not significant (P < or = .05). The results indicate that progressive resistance exercise training seems to improve muscular strength and wheelchair performance in selected disabled children.

Adolescent↗
PubMedDate not supplied

Evaluation of wheelchair back support crashworthiness: combination wheelchair back support surfaces and attachment hardware.

Automotive seats are tested for compliance with federal motor vehicle safety standards (FMVSS) to assure safety during impact. Many wheelchair users rely upon their wheelchairs to serve as vehicle seats. However, the crashworthiness of these wheelchairs during impact is often unknown. This study evaluated the crashworthiness of five combinations of wheelchair back support surfaces and attachment hardware using a static test procedure simulating crash loading conditions. The crashworthiness was tested by applying a simulated rearward load to each seat-back system. The magnitude of the applied load was established through computer simulation and biodynamic calculations. None of the five tested wheelchair back supports withstood the simulated crash loads. All failures were associated with attachment hardware.

Accidents, Traffic↗
PubMed1989

Optimum cycle frequencies in hand-rim wheelchair propulsion. Wheelchair propulsion technique.

To study the effect of different cycle frequencies on cardio-respiratory responses and propulsion technique in hand-rim wheelchair propulsion, experienced wheelchair sportsmen (WS group; n = 6) and non-wheelchair users (NW group; n = 6) performed wheelchair exercise tests on a motor-driven treadmill. The WS group wheeled at velocities of 0.55, 0.83, 1.11 and 1.39 m.s-1 and a slope of 2 degrees. The NW group wheeled at 0.83, 1.11 and 1.39 m.s-1 and a 1 degree slope. In each test, a 3-min period at a freely chosen cycle frequency (FCF: 100%) was followed by four 3-min blocks of paced cycle frequencies at 60%, 80%, 120% and 140% FCF. Effects of both cycle frequency and velocity on physiological and propulsion technique parameters were studied. Analysis of variance showed a significant effect (p less than 0.05) of cycle frequency on oxygen cost and gross mechanical efficiency in both the WS and NW group. This indicated the existence of an optimum cycle frequency which is close to the FCF at any given velocity. The optimum cycle frequency increased with velocity from 0.67 to 1.03 cps over the range studied (p less than 0.05). Oxygen cost was approximately 10% less at 100% FCF than at 60% or 140% FCF. Gross mechanical efficiency for the WS group at 100% FCF was 8.5%, 9.7%, 10.4% and 10.1%, respectively, at the four velocities.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

A biomechanical and ergonomic evaluation of patient transferring tasks: wheelchair to shower chair and shower chair to wheelchair.

A laboratory study was conducted to evaluate five different manual techniques (two-person manual lifting; rocking and pulling the patient using a gait belt with two persons; walking belt with one and two persons) and three different mechanical hoists (Hoyer lift, Trans-Aid and Ambulift) for transferring patients from wheelchair to shower chair and shower chair to wheelchair. Six female nursing students with prior patient transfer experience served both as nurses and as passive patients. Static biomechanical evaluation showed that the mean trunk flexion moments, erector spinae muscle forces and compressive and shear forces at the L5S1 disc for the four pulling methods ranged from 92 to 125 Nm, 1845 to 2507 N, 1973 to 2641 N and 442 to 580 N, respectively, as compared to about 213 Nm, 4260 N, 5050 N and 926 N for two-person manual lifting. Perceived stress ratings for the shoulder, upper back, lower back and whole body were significantly lower for pulling methods than those for lifting the patient (p less than or equal to 0.01). Patients found pulling techniques, except the gait belt, to be more comfortable and secure than the lifting method (p less than or equal to 0.01). However, most of the nurses believed that Medesign and the one-person walking belt would not work on those patients who cannot bear weight and those who are heavy, contracted or combative. A two-person walking belt was the most preferred method. Two out of three hoists (Hoyer lift and Trans-Aid) were perceived by the nurses to be more stressful than one- and two-person walking belts. The patients found these two hoists to be more uncomfortable and less secure than with three of the five manual methods (one- and two-person walking belts and Medesign). Pulling techniques and hoists took significantly longer amounts of time to make the transfer than manually lifting the patient (p less than or equal to 0.01). The two-person walking belt, using a gentle rocking motion to utilize momentum and a pulling technique, and Ambulift are recommended for transferring patients from wheelchair to shower chair and shower chair to wheelchair.

Baths↗
PubMed1981

The mechanical efficiency of wheelchair dependent women during wheelchair ergometry.

Few previous studies have attempted to study the response of disabled women to work in a wheelchair. The purpose of this study was to investigate the mechanical efficiency of wheelchair dependent women (WCD) during progressively loaded wheelchair ergometry. Five WCD subjects with an average confinement of 17.8 years were compared to five able bodied women (AB). Neither maximal oxygen uptake, 1.121 WCD and 1.485 AB (L X min-1) or maximal power outputs, 41.6 WCD and 44.1 AB (watts) were significantly different for the groups. The WCD group, however, demonstrated significantly higher mechanical efficiencies at comparable power outputs, p greater than 0.05. This difference remained when comparisons at about 60, 80, and 90% of VO2 max were made. The average efficiencies over these metabolic levels were 14% WCD and 10.6% AB. Stroke length consistently reduced as power outputs increased with the values lower for the WCD subjects. Average values for the submaximal workloads were 3.17 WCD and 3.76 AB (m x stroke-1) which meant a difference that was 18.6% greater in length for the AB group. The possible influence of this upon the efficiency of wheelchair locomotion was discussed.

Adult↗
PubMed1994

Wheelchair propulsion: functional ability dependent factors in wheelchair basketball players.

The aim of this study was to examine the user-related parameters, 1) force generation 2) maximal aerobic power and 3) propulsion technique, in respect to functional ability level [ISMWSF] wheelchair basketball classification: groups 1, 2 and 3) of 40 elite wheelchair basketball players. Isometric (position on the handrims = -30, 0 degrees, +30 degrees and +60 degrees) and dynamic force application (velocities = 0.56, 0.83 and 1.11 m.s-1) on the handrims (test 1) was measured by means of a computerised wheelchair simulator, with the subjects sitting in a standardised position. Each subject performed a maximal exercise test (test 2) on a motor driven treadmill at 1.67 m.s-1 and four subsequent submaximal tests (test 3) at two exercise levels (60 and 80% of individual VO2) and two velocities (1.11 and 2.22 m.s-1) with constant power output. In tests 2 and 3, cardiorespiratory and kinematic data were recorded simultaneously. Although no significant differences between functional ability groups were found in relation to force application on the handrims, three different force application strategies were observed (test 1). Maximal aerobic capacity and power output (test 2) differed significantly (p < 0.05) between groups 1 and 2 and between groups 1 and 3. No differences in mechanical efficiency were observed between the three functional ability groups, irrespective of changes in wheelchair velocity and external load (test 3). Propulsion technique was not proven to be functional ability dependent although remarkable differences in movement pattern were observed, especially during the recovery phase.

Activities of Daily Living↗
PubMed1991

A biomechanical and ergonomic evaluation of patient transferring tasks: bed to wheelchair and wheelchair to bed.

A laboratory study was conducted in an effort to reduce back stress for nursing personnel while performing the patient handling tasks of transferring the patient from bed to wheelchair and wheelchair to bed. These patient handling tasks were studied using five manual techniques and three hoist-assisted techniques. The manual techniques involved one-person and two-person transfers. One manual technique involved a two-person lift of the patient under the arms; the others used a rocking and pulling action and included the use of assistive devices (a gait belt using a two-person transfer, a walking belt with handles using a one-person and a two-person transfer, and a patient handling sling with cutout areas to allow for a hand grip (Medesign) for a one-person transfer). The three mechanical hoists were Hoyer, Trans-Aid and Ambulift. Six female nursing students with prior patient transfer experience served both as nurses and as passive patients. Static biomechanical evaluation showed that pulling techniques, as compared to lifting the patient, required significantly lower hand forces and produced significantly lower erector spinae and compressive forces at the L5/S1 disc (P greater than or equal to 0.01). Shear force, trunk moments and the percentage of females who were capable of performing the transfers (based on static strength simulation) also favoured pulling methods. Perceived stress ratings for the shoulder, upper back, lower back and whole body were lower for pulling methods than those for lifting the patient (P less than or equal to 0.01). Patients found the pulling techniques, with the exception of when using the gait belt, felt more comfortable and more secure than the lifting method (P less than or equal to 0.01). However, a number of subjects believed that the patient handling sling (Medesign) and the walking belt with one person making the transfer would not work for those patients who could not bear weight and those who were heavy, contracted or combative. A walking belt with two persons was the preferred manual method. Two out of three hoists (Hoyer lift and Trans-Aid) were perceived by the nurses to be as physically stressful as manual methods. Patients found these two hoists to be more uncomfortable and felt less secure than with three of the five manual methods (one- and two-person walking belts and Medesign). Ambulift was found to be the least stressful, the most comfortable, and the most secure among all eight methods. Pulling techniques and hoists took significantly longer amounts of time to make the transfer than manually lifting the patient (P less than or equal to 0.01). The two-person walking belt using a pulling technique and Ambulift are recommended for transferring patients from bed to wheelchair and wheelchair to bed. A large-scale field study is needed to verify these recommendations.

Adult↗
PubMed1997

A survey of wheelchair use by paraplegic individuals in Japan. Part 1: Characteristics of wheelchair cushions.

The characteristics of wheelchair cushions used by 218 paraplegic patients who lived independent lives were surveyed to clarify the present state of wheelchair cushioning for pressure sore prevention in Japan. Out of 586 cushions surveyed, 91.0% were ready-made and the rest were custom-made. The outstanding popularity of polyurethane foam ready-made cushions (76.3%) suggested that insufficient consideration was taken in the selection of cushions. Custom-made cushions displayed unique modifications to relieve contact pressure or to stabilize sitting posture, which should be systematically provided for all patients. The variety of cushion types and the frequent dissatisfaction with cushions seen in patients with current pressure sores suggested a strong demand for the effective prescription of cushions. Furthermore, 30% of all cushions had had an excessively prolonged use, indicating insufficient follow-up. A medical system including deliberate prescription and regular follow-up of wheelchair cushions should be established for the effective prevention of pressure sores.

Adolescent↗
PubMed2001

The COSTAR wheelchair study: a two-centre pilot study of self-propulsion in a wheelchair in early stroke rehabilitation. Collaborative Stroke Audit and Research.

OBJECTIVE: It is uncertain whether self-propulsion in a wheelchair should be encouraged or discouraged in the early stages of stroke rehabilitation. DESIGN: A two-centre pilot study to assess the feasibility of performing a multicentre randomized controlled trial on this subject. SETTING: Clatterbridge and Aintree Stroke Rehabilitation Units, Merseyside, UK. SUBJECTS: Forty early stroke patients (mean age 67 years) in whom it was uncertain whether self-propulsion in a wheelchair should be encouraged were studied. INTERVENTION: A central randomization service at Newcastle University was used to determine the policy about wheelchair provision and use for each patient. They were allocated to either an 'encouraged to self-propel' or a 'discouraged from self-propulsion group'. OUTCOME MEASURES USED: Independent outcome assessment was performed by postal questionnaire and telephone interview using the Barthel ADL Scale, Nottingham Extended ADL Scales and the shortened General Health Questionnaire (GHQ-12) at 3 and 12 months. Patient's length of stay and their Ashworth tone score were also measured either at three months or when they were discharged from hospital. RESULTS: After considerable preparation time it was possible to conduct a trial on self-propulsion in early stroke rehabilitation in the two-pilot centres. No major differences were found between the pilot groups for any of the outcome measures. CONCLUSIONS: A multicentre randomized controlled trial to assess this question is feasible but further work is being conducted before proceeding, to satisfy the concerns expressed to our group regarding the appropriateness of the intervention and the outcome measures.

Aged↗
PubMedDate not supplied

Hybrid-powered wheelchair: a combination of arm force and electrical power for propelling a wheelchair.

Many of the handicapped who could use a hand-driven wheelchair do not have sufficient arm force, arm movement and/or endurance for proper propulsion. Furthermore, there are users of electric wheelchairs who still have some arm functions and strength. In some cases a hand-driven chair, which can be propelled with reduced arm power, could be a better solution. By means of simulation, a study has been carried out to investigate the possibility of propelling a wheelchair by means of hybrid powering. Hybrid powering can be defined as a combination of arm force and electrical power. Using this hybrid principle, the necessary arm force can be decreased.

Arm↗
PubMedDate not supplied

Cortisol and testosterone concentrations in wheelchair athletes during submaximal wheelchair ergometry.

It is yet unknown how upper body exercise combined with high ambient temperatures affects plasma testosterone and cortisol concentrations and furthermore, how these hormones respond to exercise in people suffering spinal cord injuries. The purpose of this study was to characterize plasma testosterone and cortisol responses to upper body exercise in wheelchair athletes (WA) compared to able-bodied individuals (AB) at two ambient temperatures. Four WA [mean age 36 (SEM 13) years, mean body mass 66.9 (SEM 11.8) kg, injury level T7-T11], matched with five AB [mean age 33.4 (SEM 8.9) years, mean body mass 72.5 (SEM 13.1) kg] exercised (cross-over design) for 20 min on a wheelchair ergometer (0.03 kg resistance.kg-1 body mass) at 25 degrees C and 32 degrees C. Blood samples were obtained before (PRE), at min 10 (MID), and min 20 (END) of exercise. No differences were found between results obtained at 25 degrees C and 32 degrees C for any physiological variable studied and therefore these data were combined. Pre-exercise testosterone concentration was lower (P < 0.05) in WA [18.3 (SEM 0.9) nmol.l-1] compared to AB [21.9 (SEM 3.6) nmol.l-1], and increased PRE to END only in WA. Cortisol concentrations were similar between groups before and during exercise, despite higher rectal temperatures in WA compared to AB, at MID [37.21 (SEM 0.14) and 37.02 (SEM 0.08) degrees C, respectively] and END [37.36 (SEM 0.16) and 37.19 (SEM 0.10) degrees C, respectively]. Plasma norepinephrine responses were similar between groups. In conclusion, there were no differences in plasma cortisol concentrations, which may have been due to the low relative exercise intensities employed. The greater exercise response in WA for plasma testosterone should be confirmed on a larger population. It could have been the result of the lower plasma testosterone concentrations at rest in our group.

Adult↗
PubMed1996

The effect of wheelchair handrim tube diameter on propulsion efficiency and force application (tube diameter and efficiency in wheelchairs).

To determine the optimum tube diameter of a standard handrim-propelled wheelchair, the effect of tube size and shape on physiological and kinetic parameters was studied. Six able-bodied male subjects performed two tests on a wheelchair ergometer. Tests were performed against work loads comparable to every day use and with two different handrim tube diameters, a handrim with an oval 25 by 30 mm diameter (LR) and one with an 18 mm diameter (SR). The large tube diameter (LR) yielded slightly but significantly lower values for the physiological parameters. Gross mechanical efficiency was on average 7% for the LR and 6.3% for the SR. No significant results were found for force application parameters related to the direction of the applied force or the torque by the hand onto the handrim surface. As technique parameters could not explain the higher mechanical efficiency (ME) when using the LR, it is suggested that hand grip constraints in the push phase (finger flexor activity) might be responsible. Another possible explanation is that with a better hand grip using LR, less stabilization by the larger muscle groups at the elbow and shoulder is needed. The measured technique parameters seem to be determined by geometric constraints of the arm and shoulder. The technique requirements resulting from the forced trajectory of the propulsion movement are also likely to determine the technique parameters. Regarding the low mechanical efficiency of handrim propulsion, which is partly caused by the forced unfavorable trajectory of the hand, an alternative propulsion mechanism is suggested.

Adult↗
PubMed1991

Within-cycle characteristics of the wheelchair push in sprinting on a wheelchair ergometer.

To investigate power output and torque production in wheelchair sprinting, six able-bodied subjects performed nine 20-s sprint tests on a stationary wheelchair ergometer (load 0-8 kg). Ergometer data were analyzed and combined with kinematic data and surface electromyography. Of all power and torque parameters investigated, only maximal power output was independent of load (mean peak value 375 W, one-sided). Mean power output is suggested to be a useful indicator for anaerobic power production, but test conditions concerned speed in relation to handrim diameter should be specified. The relevance of the "mechanical constraint principle" for handrim propulsion is discussed. Within one cycle, power and torque curves showed a negative deflection at the beginning and a valley approximately halfway through the push phase. The relation of these phenomena to kinematic parameters and muscle activity is discussed.

Acceleration↗